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Inicio Endocrinología, Diabetes y Nutrición (English ed.) Retrospective observational study on real world use of the Minimed™ 780G autom...
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Vol. 71. Issue 6.
Pages 229-235 (June - July 2024)
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Vol. 71. Issue 6.
Pages 229-235 (June - July 2024)
Original article
Retrospective observational study on real world use of the Minimed™ 780G automated insulin delivery system: Impact of the settings on autocorrection and omitted meal boluses
Estudio observacional retrospectivo sobre el sistema Minimed™ 780G en vida real: impacto de la configuración sobre la autocorrección y la omisión de bolus prandiales
Fidel Jesús Enciso Izquierdo, María José Amaya García
Corresponding author
mariajoseamayag@gmail.com

Corresponding author.
, Ana Alejandra Cordero Vaquero, Jose Antonio Lucas Gamero, Paula Gomez-Barrado Turégano, María Luengo Andrada, Andrea Cordero Pearson, Rocío Jazmín Grau Figueredo
Unidad de Endocrinología y Nutrición, Hospital Universitario San Pedro de Alcantara, Cáceres, Spain
Article information
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Figures (1)
Tables (3)
Table 1. Glycemic parameters, distribution of daily insulin dose, and adjustable parameters of the MiniMed™ 780G system configuration.
Table 2. Correlation between the percentage of autocorrection bolus insulin and glycemic parameters and MiniMed™ 780G system parameters.
Table 3. Percentage of insulin administered in autocorrection boluses based on the No. of prandial boluses per day.
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Abstract
Introduction

The Medtronic MiniMed™ 780G (MM780G) system uses an algorithm that includes autocorrection bolus (AB) delivery. This study evaluates the impact of omitted meal boluses and the system settings, glucose target and active insulin time (AIT), on the AB.

Method

Retrospective observational study on data uploaded by all MiniMed 780G users in our healthcare area, obtained through the remote monitoring platform Care Connect, from April to August 2023. Downloads with a sensor usage time <95% were excluded.

Results

235 downloads belonging to 235 users were analysed. AB delivery was significantly higher at 2 h AIT (36.08 ± 13.17%) compared to the rest of settings (2.25–4 h) (26.43 ± 13.2%) (p < 0.001). AB differences based on the glucose target were not found.

Patients with <3 meal boluses per day had higher AB delivery (46.91 ± 19.00% vs 27.53 ± 11.54%) (p < 0.001) and had more unfavourable glucometric parameters (GMI 7.12 ± 0.45%, TIR 67.46 ± 12.89% vs GMI 6.78 ± 0.3%, TIR 76.51 ± 8.37%) (p < 0.001). However, the 2-h AIT group presented similar TAR, TIR and GMI regardless of the number of meal boluses.

Conclusion

The fewer user-initiated boluses, the greater the autocorrection received. The active insulin time of 2 h entails a more active autocorrection pattern that makes it possible to more effectively compensate for the omission of meal boluses without increasing hypoglycaemias.

Keywords:
Type 1 diabetes
Hybrid closed loop
Bolus omission
Meal bolus
Glycaemic outcomes
Resumen
Introducción

El sistema Medtronic MiniMed™ 780G (MM780G) utiliza un algoritmo que incluye la administración automática de bolus de autocorrección (BA). Este estudio evalua la influencia de la omisión de bolus prandiales y de los parámetros modificables del sistema, objetivo glucémico y duración de insulina activa (DIA), sobre el BA.

Método

Estudio observacional retrospectivo sobre las descargas de todos los usuarios del dispositivo MM780G de nuestro área de salud, obtenidas a través de la plataforma de seguimiento remoto Care Connect, de abril a agosto de 2023. Se excluyeron descargas con un tiempo de uso del sensor < 95%.

Resultados

Se analizaron 235 descargas pertenecientes a 235 usuarios. El BA fue significativamente mayor con DIA de 2 horas (36,08% ± 13,17%) frente al resto de duraciones (2,25 - 4 horas) (26,43% ± 13,2%) (p < 0,001). No observamos diferencias del BA en función del objetivo glucémico.

Los pacientes con < 3 bolus prandiales diarios recibían mayor BA (46,91 ± 19,00 % vs 27,53 ± 11,54%) (p < 0,001) y tenían parámetros glucométricos más desfavorables (GMI 7,12 ± 0.45%, TIR 67,46 ± 12,89% vs GMI 6,78 ± 0,3%, TIR 76,51 ± 8,37) (p < 0,001). Sin embargo, el grupo de DIA de 2 horas, presentó similares TAR, TIR y GMI independientemente del número de bolus prandiales.

Conclusión

La autocorrección es mayor cuanto menos bolus prandiales se administran. La DIA de 2 horas conlleva un patrón de autocorrección más activo que permite compensar más eficazmente la omisión de bolus prandiales sin incremento de hipoglucemias.

Palabras clave:
Diabetes tipo 1
Sistema de asa cerrada
Omisión de bolus
Bolus prandial
Control glucémcio

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